McCaskill Drafts Bill Aimed at Giving States Power to Regulate Air Ambulances

The legislation would force air ambulance providers to clearly separate the transportation costs from the cost to provide care on a consumer’s bill.

by Samantha Liss, St. Louis Post-Dispatch
/
May 10, 2018

(TNS) - Sen. Claire McCaskill, D-Mo., plans to introduce legislation Thursday that would allow states to regulate the medical costs of air ambulances.

The legislation would force air ambulance providers to clearly separate the transportation costs from the cost to provide care on a consumer’s bill.

McCaskill’s Air Ambulance Consumer Protection Act partially carves out air ambulances from federal regulation, a step that would open the door for state insurance departments to regulate air ambulances.

Currently, states are barred from regulating the price and routes of air carriers due to the Airline Deregulation Act of 1978. Under federal law, air ambulances are considered air carriers.

That has made it hard for states to intervene when consumers are hit with significant air ambulance bills.

“Air ambulances, while they provide a lifesaving service, are currently operating in a gray area between health care and aviation, and have managed to not be held accountable by anyone — and it’s time for that to change. This bill will allow states to properly regulate air ambulance costs, which have skyrocketed in the last decade, and give consumers much-needed protections,” McCaskill said in a statement.

The legislation comes after the Post-Dispatch reported on a family whose son was sent by air ambulance after suffering a skull fracture, leaving them with an outstanding bill of about $32,000. That was followed by a story about at least 10 other families stuck with air ambulance bills ranging from $27,000 to $51,000.

The problem was blamed on a lack of in-network air ambulance providers. The state’s two largest insurance companies — Anthem Blue Cross Blue Shield and UnitedHealth — do not have any in-network air ambulances through direct contracts.

Insurance industry representatives told the Post-Dispatch there is no incentive for air ambulance companies to join a network.

“This is what happens when an insurance provider is not able to negotiate those lower prices for you. You as a consumer are left to see the entire impact of the out-of-control prices,” Kristine Grow, spokeswoman for America’s Health Insurance Plans, said.

The Air Ambulance Consumer Protection Act calls for the formation of an advisory committee to make recommendations that could lead to additional consumer protections, according to a draft of the bill.

The advisory committee would be made up of state insurance regulators, insurance providers, consumer groups and air ambulance companies, according to a draft of the bill.

Air ambulance providers would be required to include a hotline number on bills for consumers who may have complaints. The hotline is operated by the Department of Transportation.

McCaskill’s bill mirrors the language included in the House bill that reauthorizes the Federal Aviation Administration. That bill was passed in late April.

Representatives for the air ambulance industry were critical of the language in the House reauthorization bill. They say it will create a situation where insurers will pay only for the care aboard the aircraft and not the transportation.

McCaskill’s proposed legislation comes after she sent letters to nine air ambulance providers and health insurers looking for answers on their practices following the Post-Dispatch reporting on the issue.